Let's Discuss Why We (Humans) Are Gross (Part 1)

Some people think dogs are cute, some are terrified with them and some just think they are gross. Every single one of us has their version of acceptable things that they can/can't tolerate throughout their lives. Some people don't mind handling people's vomit or basically anything that came out from human being while others, they vomit at the first sight of the same thing.

Some people can't see blood or they will vomit or worst, being unconscious. What determines whether we can or cannot tolerate certain things? Well, we will discuss that another time. In this article, I'm going to list out 3 things that people seem to be grossed with, anything that might comes out from a human being.

Silent But Deadly

Sometimes I am born in silence,
Other times, no.
I am unseen,
But I make my presence known.
In time, I fade without a trace.
I harm no one,
but I am unpopular with all. ~ Source

What am I?

Let me tell you a story regarding how meticulous academicians in the past trying to learn and understand fart. When we are talking about flatulent, Michael D. Levitt (Levitt MD) can be considered as the star of the show. He has conducted various experiments to understand flatulence including determining the source of gases in people who presented with severe flatulent.

The idea is to determine whether the pathological flatulence was caused by gases which are either originated from swallowed air or as a byproduct released by the intestinal bacteria. It turns out, he got an idea how to differentiate both of them; swallowed air usually contains a high percentage of nitrogen compared to gases produced by intestinal bacteria which comprised of primarily carbon dioxide, hydrogen and methane.

I'm not sure how we are going to treat people who have been swallowing too much air but according to Levitt, this is an essential step before deciding what kind of treatment we want to prescribe to the patient. It's essential however to teach patients how to differentiate between the normal and abnormal frequency of farting; farting more than 20 times a day were considered abnormal.

After that, if the patient is indeed abnormal, a gas analysis would be conducted and subsequently, treatment would be provided based on the origin of gases contained in the fart. It's a lot of steps before we can decide the mode of treatment of excessive flatulence. Nowadays, we have a few types of medications which are designed to treat excessive flatulence (charcoal tablet being one of them) or if it doesn't work, at least we can curb the smell and sound by wearing a special kind of underwear equipped with pads.

Some people might think that farts are gross but they are one of the most important things that we have that will allow us to live healthily. Even if most of the gases which are excreted as farts contained mostly swallowed air, there is a tiny percentage of gases which are the byproduct of digestion which needs to be expelled after they were produced, like pronto.

Fun fact, between men and women, the latter might have a much worse smelling fart since women's bodies would excrete a higher percentage of sulphur (in the form of hydrogen sulphide) compared to men.

Can You Burp All Of The Alphabets?

Why fart and waste it,
When you can burp and taste it? ~ By kimbykat

Sometimes they were called the mouth fart but then again, people might misunderstand with the term as some people were using those words to describe the expulsion of air (pffft) when someone was being stupid. Some people considered burping as an alternative to farting when your body was trying to expel the excess air which might have negatively affect you.

Foods or anything that we swallowed will stay in the stomach for a significant number of hours before they could pass through the pyloric sphincter and progresses through the intestine. They will be digested by various agents (enzymes, gastric juice etc.) which will result in the production of byproducts including gases mainly carbon dioxide, accompanied by a few others such as hydrogen and methane.

If we combine the gases which are produced by the digestive processes in the stomach along with anything that we swallowed (including air), the pressure build-up in our stomach will be too much than what our oesophagal sphincter can handle, which usually manifest itself as a feeling of discomfort. To relieve the pressure, the sphincter would be forced to open which will result in burping. It's completely normal, unless, you burp too much.

Some patients would be able to burp 20 times in a minute (that's right, one minute), it is hard to miss especially when a doctor trying to get a history from a burping patient. The diagnosis, however, can be tricky. Patients with reflux disease or often known as GERD were usually presented with an abnormal frequency of belching which can be caused by abnormal gas production related to acid reflux. Sometimes, patients came with the burping alone making it hard to establish a diagnosis.

In some patients, belching can be reduced by some kind of distractions such as while they were filling a form or while they were doing something interesting etc.; it can be psychological whereby the symptoms would become worse only during observation or they were aware of that particular symptom. Psychiatric disorders such as depression, anxiety etc., if combined with gastrointestinal abnormalities can cause an unusual frequency of belching.

Management of excessive belching would focus on the underlying condition in which the patient currently presented with. It is unusual for us to investigate the cause of belching alone and often we treat belching as one of the presentations of gastrointestinal disorder. However, if the belching doesn't stop even after the underlying condition has been treated then some special investigations (which are quite costly) would be carried out to identify the problem.

People Who Tell You That They're Constipated Are Full Of Crap

I ate four cans of alphabet soup yesterday.
Then I had probably the biggest vowel movement ever. ~ Source

Now, we will discuss, one of the most disgusting products of a human being; the poop/crap/shit. Even though it is not the most likable product, it can give us a lot of clinical information regarding a patient who is suspected to have certain diseases. In medical school, we are taught to extract as much info as we could from a specific type of patient regarding their stool's colour, consistency, frequency etc.; that's how important a stool is for a clinician. It gives us clue on how to proceed with a particular case. Let's take a look at two symptoms associated with stools.

Have you seen that new movie Constipated?
It's not come out yet. ~ Source

There are a few patient's conditions which we can classify them as being constipated; they are either having a reduced urgency to pass motion (less than 3 times per week) or people who refused or having some kind of difficulty in passing motion due to dry and hard stool or they felt painful while passing motion thus making them reluctant to try at all. Regardless, they were facing the same problem.

It's quite rare for people to experience constipation, solitarily. Most of them presented with other symptoms that might give us some clues regarding the diagnosis that we are trying to achieve. There were a lot of criteria for constipation depending on the age (paediatric patient would be using a different kind of criteria compared to the adult population) but I'm not going to discuss that now.

Regardless, digital rectal examination (using fingers to assess severity) can be useful at a time. An experienced clinician must perform it as it is quite difficult for an inexperienced one to determine; taking a long time to assess can be awkward for both the patient and the doctor in charge. I mean, your finger is in my ass and it has been a while now, do you find anything?

Before we decide to give some kind of pharmacological treatment to patients with constipation, it is advisable for us to encourage patients to change their lifestyle by making dietary changes, exercise, eat more foods which are rich in fibre etc.. If none of it works, stool softeners or any kind of pro-kinetic agent would be given to ease up the passing processes, whatever the management is, that shit must be expelled or it could get a lot worse than constipation.

And have you seen the sequel, Diarrhea?
It leaked so they had to release it early. ~ Source

I would say that, among all of the consistency, this one is probably the most stressful to have. I mean, we can't seem to differentiate whether we want to fart or along the way, some of the super soft stool would hitch the air-ride. Laughter might be the best medicine, but if you have diarrhoea, it could get a lot worse.

The most popular opinion among people who were having diarrhoea is that it's caused by something they ate. If food poisoning is the reason, then you will have nothing to worry about, it probably self-limiting and you should get hydrated as much as you can. Taking antibiotics when you were having a food poisoning can be futile as it sometimes can worsen the symptoms or prolonged it; we wouldn't want either plus it can lead to the emergence of resistant bacteria.

A bacterial toxin is one of the potential causes of diarrhoea as it can stimulate the intestine to release an excessive amount of water causing the production of an incredibly soft stool. Some bacteria would even destroy the lining of the mucosal wall which would produce a bloody diarrhoea that we usually called as dysentery. Some patients with colonic diseases of chronic onset could also present with diarrhoea but in this case, the aetiological agent couldn't be microbial agents. It is caused by the pathophysiological processes of the disease itself.

In some cases of parasite infestation, taking and analysing stool sample can easily be the most critical part of an investigation to confirm or rules out diagnoses. Microscopic investigations can determine what kind of parasite that a patient might have been infested with before we can start any kind of treatment specific to that cause.

I think that's enough for this article. I have divided this topic into a few parts so next week, I would write another. Stay tuned.

References: [1], [2], [3], [4], [5], [6], [7]

All images were taken from Pixabay

Images: [1], [2], [3], [4], [5], [6], [7]